Society for Social Work and Research 17th Annual Conference: Social Work for a Just Society: Making Visible the Stakes and Stakeholders

January 16 - 20, 2013

The substance abuse treatment (SAT) system faces an unprecedented challenge to reduce health disparities among low-income and racial and ethnic minority populations, which require culturally responsive and evidence-based treatment practices (EBPs). Yet, SAT providers face significant barriers to decreasing their reliance on practices supported by traditional norms and program routines and effectively implementing innovative approaches with demonstrated impact on treatment outcomes. Barriers to effectively implementing EBPs in community-based settings are associated with introducing change in hectic, poorly resourced programs with unstable funding, passive leadership, high staff turnover, and limited technical resources to conduct clinical operations and support effective decision-making.

The goal of this symposium is to provide a comprehensive examination of the multiple factors associated with organizational capacity to implement culturally responsive and EBPs among community-based SAT organizations in the United States. The organizational process associated with building capacity to implement new technologies or knowledge that successfully engages clients in SAT has been described and tested by the organizational readiness-for-change framework. This framework highlights staff motivation and attributes, as well as program resources and climate, as key analytical constructs in the process of adopting, implementing, and routinizing new practices. In particular, the Organizational Readiness for Change framework developed at Texas Christian University (TCU-ORC) encompasses the following four domains measured by several subscales; need and pressures for change (4 scales), resources (6 scales), staff attributes (6 scales), and organizational climate (6 scales).

This symposium is unique in that it presents findings from three different studies on community-based treatment in which TCU-ORC is examined as an independent, mediating, and dependent variable. All four papers utilize TCU-ORC scales to explain the following four areas of the implementation process: (1) the predictive role of staff education in program readiness for change; (2) the mediating role of readiness for change in the implementation of culturally responsive practices; and the predictive role of readiness for change in (3) increasing fidelity to implement EBPs; and (4) training staff on EBP implementation. As such, presenters will engage the audience in discussion about conceptual, analytical, process and sample-specific issues associated with building organizational capacity among community-based providers across the United States. All papers in the symposium will address the following two questions:

(1)   How do findings contribute to the evidence base relevant to the implementation process of culturally responsive and evidence-based practices among SAT organizations?

(2)   What are implications of findings for developing organizational capacity in community-based SAT settings to improve standards of care for vulnerable populations?

Identifying promising leverage points to implementing evidence-based care in community-based SAT is critical because these providers are vital health care assets that are well positioned to reduce health disparities if they can ensure access to effective care for low-income and racial and ethnic minority populations. Current initiatives emerging from health care reform will precipitate a significant change that presents a great opportunity for social work practice that relies on evidence-informed processes and interventions to improve standards of care and reduces health and service disparities for underserved populations.